Noninvasive procedures such as physical therapy and chiropractic treatment are often the choices for relief of the symptoms of degenerative disc disease, but sometimes these therapies are not enough. Dr. Jack Zigler, an orthopedic surgeon with Texas Back Institute, states that when the pain is severe and debilitating, waiting for conservative therapies to take effect may not be possible. When degenerative disc disease has failed to respond to more conservative treatments, surgery is the next avenue patients might want to consider.
Spinal Fusion
Spinal-fusion surgery prevents any further motion in the area of the spine in which disc degeneration has occurred. It stops joint movement from impinging on spinal nerves and causing pain. Spinal-fusion surgery involves the removal of the damaged disc, followed by the use of bone grafts and metal braces to force the vertebrae adjacent to the damaged disc to grow together as one segment of bone. It is sometimes deemed less desirable because it precludes future mobility of the joint. Spinal fusion can be performed in the lumbar, cervical or thoracic spine, but is typically only desirable when a single disc is involved, rather than multiple discs.
Spinal-fusion surgery previously was considered the only surgical option for disc degeneration, but surgical techniques have been developed that offer patients more options.
Microdiscectomy
Microdiscectomy, also known as microdecompression, is a less-drastic surgical measure for addressing disc degeneration. Rather than remove the entire disc, a small portion of either the disc or vertebral bone are surgically excised. This is an outpatient procedure, typically involving no overnight hospitalization, or at most one night of recuperation in a hospital, orthopedic surgeon Peter Ullrich explains. Recovery time is shorter than with spinal fusion, and relief of leg pain often associated with lumbar disc degeneration is almost immediate.
Artificial Disc Replacement
Artificial disc replacement offers patients the option of replacing the damaged disc with a prosthetic disc. This procedure has the advantage of maintaining the mobility of the vertebral segments adjacent to the replaced discs, as well as the disc height, thus preventing any impingement on spinal nerve roots due to disc thinning. Cedars-Sinai Medical Center advises that artificial disc replacement is a reversible procedure and, unlike spinal fusion, is not associated with increased degeneration of the spinal segments surrounding the treated area.
